Drug use disorders among long distance commercial vehicle drivers

This study investigates substance use disorders among long-distance commercial vehicle drivers in Kaduna, Nigeria. Each consecutive 4th long distance driver who was to load his vehicle on each day was interviewed using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to generate an International Classification of Diseases (ICD-10) substance use diagnosis until a sample size of 274 was attained. The data was analysed using the SPSS version 16.0. The current and life time prevalence of an ICD-10 diagnosis was 18.4%, and 21.2% respectively. None of them had received any form of medical treatment for drug problems. Substance use disorder occur among long distance commercial vehicle drivers, and there is a need to develop a system that identifies substance use disorders and provides treatment for drug users as part of a holistic approach against drugged-driving.Keywords: Drug-use disorders, long-distance commercial drivers, Nigeri

Medication compliance behavior in psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian tertiary hospital

Background: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity.Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital.Settings and Design: A cross‑sectional study of a tertiary hospital in Northern Nigeria.Methods: Adult patients who have been attending the out‑patient clinic for at least 1 year were included. From the routine clinic, each consecutive fourth patient completed a socio‑demographic and drug use questionnaire, a self‑administered medication adherence scale, and a semi‑structured proforma which sought reasons for poor adherence, information on supervision and who keeps patient medications at home; until a calculated sample of 208 was attained.Statistical Analysis: Done by means of descriptive statistics using the Statistical Package for Social Sciences version 16. The level of significance was set at P < 0.05.Results: Totally, 208 patients participated in the study. 61 (29.3%) of them were substance users, out of which 59% never reported missing their medications. No statistically significant relationship was found between substance use and medication adherence. A significant proportion of substance users were compliant with medication use when the drugs were in their possession. For substance users and nonusers, the major reason for poor drug adherence was the unavailability of the medications, while nonsubstance users were more likely to complain about being tired of the medications. No report of side effects in supervised patients.Conclusion: The use of psychoactive substances in patients with other mental disorders influences their medication adherence behavior.Key words: Adherence, hospital, Nigeria, out‑patients, psychoactive, substanc

Behavioural Responses to the COVID-19 Pandemic among Nigerians: A Nationwide Survey

Background: COVID-19 being a new disease has been fraught with poor public social responses. This survey described the behavioural responses to  COVID-19 from individuals in a multi-ethnic and multi-cultural society like Nigeria. Methods: The study used a web-based descriptive cross-sectional design to recruit Nigerian adults, 18 years and above from all the geopolitical  zones in the country, by snowball sampling technique. A 6-page Google form survey tool was used to administer the questionnaire via emails,  WhatsApp groups and other social media platforms. Data analysis was done using descriptive statistics with percentage frequency distribution. Results: A total of 1841 respondents (45.8% females) were finally analyzed. The age range was 18-84years with mean of 31±11years. Overall, 1079  (58.6%) expressed at least one element of fear of disclosing their COVID-19 status. There were 1047 (56.7%) respondents who expressed worry  about being discriminated against if they get COVD-19 and 1087 (59.1%) agreed that family members of COVID-19 patients may be rejected by the  community. Majority 1749 (95%) stated willingness to present to the healthcare facility, though 932 (50.6%) stated they will not be attended to if  suspected to have COVID-19. Of the respondents, 794 (43.1%) indicated that COVID-19 was caused by the Chinese and 1202 (65.3%) indicated that  healthcare workers should be kept in a hotel separate from the rest of the community. Majority 1679 (91.2%) however, disagreed that COVID- 19 was  a death sentence. Conclusion: The study revealed that there were elements of fear of disclosure, with discrimination and stigmatization being the major causes of  concern

Psychometric validity of the distress thermometer and problem check list in ART-na\uefve HIV infected patients in Northern Nigeria

Background: HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention. Objectives: To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-na\uefve HIV infected patient. Materials and Methods: A total of 90 ART-na\uefve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale. Results: The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT\u2019s problem list overall and sub-categories were within acceptable range (i.e. \u3b1 > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT\u2019s cut-off was >5.0 with AUC range (0.754 \u2013 0.709); sensitivity range (81.0% \u2013 70.4%); specificity range (68.3% \u2013 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 \u2013 0.821); sensitivity range (90.5% - 85.7%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as measured by HADS. Conclusion: The DT and Problem List were found to be valid measures of distress in ART-na\uefve HIV infected patients

Persistent Psychosis Occurring in a Patient Receiving Cycloserine for the Treatment of Multidrug Resistant Tuberculosis

A case of cycloserineinduced psychosis persisting after discontinuation of the drug in the treatment of  multidrug resistant tuberculosis in a 26 year old male who was been managed in the hospital for multidrug resistant tuberculosis on daily doses of Cycloserine 500mg, Pyrazinamide 1.2g, Proteonamide 500mg, Kanamy c in 750mg, Levofloxacin 750mg and Vitamin B6 200mg. At the 6th month of treatment, he developed delusional and hallucinatory experiences which subsided with the use of antipsychotics. However, antipsychotic use was not sustained leading to exacerbation of psychotic symptoms and complete abandonment of all his  anti-tubercular medications including cycloserine. Psychiatric symptoms then  progressed into florid psychosis without psychiatric treatment. In conclusion, the case report highlights the enduring psychiatric problems and its consequences that could be associated with the use of cycloserine in the treatment of tuberculosis and the need to integrate effective mental health liaison services for multidrug resistant tuberculosis treatment

Pattern and reasons for substance use among long-distance commercial drivers in a Nigerian city

Objective: To determine the pattern and reasons for psychoactive substance use by long-distance commercial vehicle drivers in a Nigerian city. Materials and Methods: All licensed long-distance commercial vehicle drivers who travel a distance of at least 500 km from the city metropolis were recruited. Each fourth consecutive driver who was to load his vehicle for the day was interviewed at the 10 long-distance motor parks. They responded to a sociodemographic and semi-structured pro forma requesting the type of drug used and the reason and pattern of use. The data obtained were analyzed by means of descriptive statistics using the statistical package for social sciences (SPSS) version 16. Results: All the respondents were males with a mean age of 43.4 years. There was no statistically significant difference between the mean age of substance users and nonusers (t = 0.491, P = 0.853). The reasons given for drug use were to keep awake while driving, for pleasure, as part of the culture, peer influence, as a substitute for food and for no obvious reason. The pattern of use tended to be related to the reason given for the use. Conclusion: The reason for drug use in long-distance drivers could be used to modify the pattern of use to minimize the risk associated with drugged driving

Psychotropic prescriptions for the treatment of schizophrenia in an outpatient clinic

Abstract Introduction There is an unpredictable pattern in the prescription of antipsychotics and other psychotropic medications for the treatment of schizophrenia, particularly in resource-limited settings in developing countries. Objective To determine the psychotropic prescriptions given to patients with schizophrenia in an outpatient clinic of a tertiary hospital and to describe the choices and trends of these prescriptions. Methods This was a cross-sectional descriptive study of prescriptions for adults with schizophrenia. After clinical consultation, patients’ case notes were randomly selected over a period of 2 years. Using a structured form, data were extracted from the case notes including biodemographic data, psychotropic medications prescribed and changes made to these prescriptions. Data were analyzed by means of descriptive statistics. Results A total of 103 patients were selected, with a mean age of 35.96±9.78 years; 48.5% were males and 51.5% were females; 33% were unemployed and 38% had been hospitalized in the past. There were 231 initial prescriptions and 228 current prescriptions, with about 2.2 prescriptions per patient. Haloperidol (mean dose 14.77±6.28mg and 11.44±5.55mg for initial and current) and other old-generation antipsychotics were the most commonly prescribed for new cases (98%). Mean duration of psychotropic use was 7.78±5.6 years. All the patients were prescribed trihexyphenidyl, and 56.3% of the patients had their medications changed as a result of side effects. Conclusion There was a very high preference for the use of first-generation antipsychotics for all treatment settings (in- and outpatients), a pattern that is likely to persist

Electroencephalographic findings in patients referred for electroencephalogram in a University Teaching Hospital in Northern Nigeria

Background: Electroencephalogram (EEG) is a valuable investigation for the assessment of patients with seizures and some other neuropsychiatric disorders. The literature is scanty of reports describing its application and usefulness in Nigerian patients. In this study we analyzed the EEG records of a series of patients who were referred with various provisional diagnoses. Materials and Methods: EEG records of the entire 200 consecutive cases referred from various clinics within and outside a tertiary hospital in Northern Nigeria during a 1 year period were analyzed. Information on biodemographic data, clinical description of symptoms and provisional diagnosis made by referring physicians and the EEG diagnosis were obtained from the records. Results: Most of the attendees were aged between 10 years and 29 years (59.5%) and mostly males (63.5%). About 80% of the attendees had received a provisional diagnosis of seizure disorder (generalized and partial). The EEG diagnosis of seizure disorder accounted for 75%, normal EEG record accounted for 21% and organic brain disorder accounted for 4% of all EEG diagnosis. Generalized seizure disorder was the commonest seizure type by EEG diagnosis (50%). There was a significant association between the provisional diagnosis and EEG diagnosis (P < 0.05). Conclusion: Most of the patients referred for the EEG had their reports consistent with clinical suspicion. EEG was found to be a useful tool in the evaluation of seizures and organic brain disorder in our study